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If they have been using corticosteroids, I will run a direct Zonulin measurement, or wait 30-60 days until they have gone off of their corticosteroid and then test Cyrex Labs Array 2
Particularly, they found a positive relation between serum D-lactate (a marker of increased intestinal permeability) and markers of hepatocytes necrosis, cholestasis, and triglycerides metabolism [47]
This depends on their B12 level and treatment needs
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